The purpose of this essay is to determine whether welfare reform since 1997 has been determined more by ideology or pragmatism. This essay offers a summary of public pronouncements made by some of New Labour’s leading thinkers in the years before they took office in order to then delve into the motivations behind them. While the focus on welfare reforms undertaken since 1997 rests with the Labour government’s policy toward the NHS, the essay establishes that there is a great deal of evidence to support the view that Labour have acted out of pragmatic considerations. Nevertheless, it is argued that policy toward reforming one of the key elements of welfare in Britain, the National health Service, in the main, has been driven by ideology.
Applauding the Attlee administration’s implementation and success of welfare policies such as the implementation of Beveridge’s National Insurance scheme, the National Health Service’s birth and a commitment to full employment, the newly elected Labour leader of 1995 posited a central strand of thinking within the ranks of the party’s modernisers. The party would ‘think the unthinkable on welfare’. ‘We need a new settlement on welfare for a new age, where opportunity and responsibility go together’ and the social policies of a future Labour government ‘should and will cross the old boundaries between left and right, progressive and conservative’ (Blair, 1995). Welfare’s new remit was/is to ‘equip citizens with the skills and aspirations they need to succeed’ which accordingly meant bestowing the ‘core skill’ of ‘entrepreneurship’ (Blair, 1998: 10-11) on welfare recipients in the context of what Brown described as an ‘information age’. The value of knowledge acquisition and it’s creative use necessitates that all workers be ‘educated, responsive to change and involved’ (Brown, 1996; Fielding, 2003: 183). Also, the ideas of modernisers in thinking about how best to promote equality with regard to welfare services were reversed with regards to, say, the ideas Beveridge fifty odd years before. The emphasis now lay squarely on bestowing equality of opportunities upon those perceived to be in most need rather than engaging with welfare policies that sought to foster an equality of outcome. ‘We reject equality of outcome’, said Gordon Brown in 1997, ‘not because it is too radical but because it is neither desirable nor feasible’ (Brown, 1997). Such statements can be easily viewed as representative indicators of policy transformation and thinking, taking place during Labour’s journey from the electoral doldrums, signalled already by the party’s (under Kinnock) late 1980s policy review. This was itself prefigured by the neo-revisionists of the 1970s ‘and some of the actions – if not quite all the thoughts – of the Callaghan government that lost power in 1979’ (Fielding, 2003: 208). They also make clear the increasing endorsement of the final report of the 1994-published ‘Commission on Social Justice’, the central theme of which came to be championed and put into practice after 1997 by chief propagators within the party. ‘The polarities of the post-war period – individual versus collective, state versus market, public versus private – are giving way to a new recognition of their interdependence’ (‘Report of the Commission on Social Justice’, Social Justice: Strategies for National Renewal, 1994: 84-85). In the main, the central tenets concerning welfare policy would not be forestalled by Labour’s leading modernisers after 1997. The rest of this essay examines key elements of welfare reform since 1997 with the focus on the National Health Service (NHS). This essay also traces the roots of the reforms in order to determine the extent to which they were inspired by thinking based on ideology or pragmatism. Chris Smith had already stated by 1996 that ‘There are some that argue that the best test of how progressive a welfare policy is, is the...
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